A Medpor mandible implant is as tough as human bones and is suitable to sculpt a relatively extended mandible angle or reshape lower face masculine images. Available in diverse models and sizes, the implants are selected and modified before the operation based on the requirements of patients, which are highly customizable. Many patients even undergo concurrent Medpor mandible and chin augmentation to forge the contour of the whole lower face. Nevertheless, such implants should be kept at a certain thickness to provide stable bone connection; the implants not only highlight the mandible angle but also make the mandible broader to increase the width of the lower face. In Dr. Chuang’s experience, they are rarely used in female patients and are mostly applied in jaw line reinforcement or congenital mandible deficiency correction in males.
The focal point of this surgery is the advanced modification of Medpor to conform to the face shape and skeletal patterns of each patient. Therefore, all patients should undergo a routine skull X-ray and 3D preoperative simulation or even a 3D CT scan if the mandible is asymmetric or problematic. After the structure of the mandible and size of Medpor are confirmed, Dr. Chuang then sculpts and trims Medpor implant preoperatively in line with imaging data in order to directly emplace it to effectively mitigate mandible bone defect during the surgery and curtail the surgical time.
The first step of this surgery is to make a 4-cm incision at the bilateral lower gums. Via the incision, the skin and muscles are detached from the mandible by an endo light sourcing system, and if necessary, the mandible is superficially or regionally shaved to make an even plane for implant emplacement. Then, the pre-trimmed and sterilized Medpor is implanted into the dissected subperiosteal space. Attention should be paid to confirm whether Medpor is closely attached to the mandible, and if it is unstable, a bone screw should be used for fixation at the perpendicular plane to avoid implant displacement, thus compromising the surgical durability. After the bilateral Medpor implants are confirmed to be right in place, the wounds are stitched.